Principles of Disease

Principles of Disease HIM 4153 Case Study: Chapter 6 Integumentary System Presentation A 58 year old male presents to your clinic with a complaint of itchy patches of red skin on his arms bilaterally. The patches are covered with loose, silvery, dry skin. The patient denies any know contact with allergens. He denies fever and any symptoms of illness. He states he has had this problem twice before, however the lesions went away in the course of a few weeks and he did not seek medical treatment. The patient's vital signs are stable and he is afebrile. He has not medical history and admits to smoking one pack of cigarettes per day. On exam, you note large, plaque-like lesions over his elbows and forearms. You also observe one similar lesion to his scalp. This patient's fingernails also appear discolored and pitting is noted. The lesions are covered with loose, flaky dry skin. They are non-tender and are not warm to the touch. You elect not to confirm your diagnosis with a skin biopsy as based on the typical presentation of this case, you are certain of your diagnosis. Management and Outcome This patient's lesions are localized to the arms, so you elect to prescribe the topical steroid Kenalog. You instruct the patient to keep the lesions well moisturized and avoid picking at or trying to peel off the lesions as this will cause his lesions to crack, bleed and become painful. You also educate this patient that sun exposure may encourage resolution of the lesions. You schedule a follow up appointment in one week. When the patient returns his lesions are still present but have decreased in size. You instruct him to continue use of topical steroids and encourage daily sun exposure to the affected area. Within the month, this patient's lesions have almost completely resolved. 1. What does afebrile mean? 2. What is the diagnosis? 3. What is the etiology of this condition? 4. Is there effective treatment for this disorder? 5. How does sun exposure improve this condition? 6. What is the prognosis? 7. Are there ways to prevent this disorder?